ROPS Specialist I (Lab)

Posting Date

General Purpose of the Job

The ROPS Specialist I (Lab) performs essential duties within various teams of Revenue Operations. This role will apply knowledge and skills to complete a wide range of tasks at a level which meets department standards and ensures goals and objectives of Revenue Operations are achieved. Teammates will perform routine tasks with some variation from standard processes and are expected to address straightforward issues with moderate supervision. Building rapport with teammates, customers, fostering positive working relationships and contributing to a sense of belonging for all is expected. Learns to manage own time effectively, balancing all demands for assigned workstream, sets and manages deadlines and monitors work results to deliver on commitments. Works to develop and improve skills and knowledge. Generates creative solutions, collaborating with others where needed to explore alternative approaches. Identifying conflicts or roadblocks on assigned work, escalates concerns, support and collaborate with others to resolve issues is imperative. Actively seeks out new insights in functional area and communicates findings. Communicates by leveraging communication tools appropriately for team and business needs, adapting tone and language for audience. This position reports to the Supervisor Revenue Operations (Lab).

Essential Duties and Responsibilities

Functions and responsibilities may include, but not limited to:
* Generates and submits claims for electronic payers by utilizing the A/R system and clearinghouse to ensure proper and timely submission of all claim files
* Resolves errors associated with claim submission rejections via the appropriate payer by researching and/or calling the payer and facilitating corrections by another department if necessary
* Maintains payer billing and clinic demographic system tables timely and accurately
* Tracks medical record requests, perform periodic billing audits
* Maintains insurance records including but not limited to the patient's eligibility and the calculation of coordination of benefits related to outpatient kidney dialysis lab testing. Teammates will utilize the patient insurance information provided by DKC ROPS, the facilities, and ancillary means to complete the registration process
* Resolves multiple discrepancies/errors in the A/R system to ensure timely claim submission
* Applies payments and/or denials to the appropriate patient claim accurately based on supporting documentation. Interprets non-cash denial line items accurately by selecting the closest related denial code in the AR system. When all efforts are exhausted, post unidentified items to unapplied cash and continues to seek resolution and perform adjustments within established department timeframes.
* Balances all posted amounts to check and batch amount; troubleshoot as necessary; resolve any out-of-balance conditions by posting adjustments and corrections for reconciliation purposes.
* Researches difficult Remittance Advices for resolution to avoid posting to the unapplied cash account by communicating with the insurance company and collections team for resolution assistance.
* Update cash batch tracking, prioritize workload, resolves work queues, and adjusts misapplied payments timely
* Takes appropriate steps to resolve credit balances, including but not limited to preparing the necessary documentation for processing a refund check from the Accounts Payable Department (Lab), requesting a recoupment from the payer, or completing an adjustment for false credits
* Evaluate credit balances in the A/R system to determine whether or not a refund is due, or an adjustment is needed
* Document pertinent information for the refund on the reversal tracking spreadsheet and address all returned checks and reprocess where applicable
* Other duties and responsibilities as assigned

• 0-2 years experience
• Minimum of 6 months medical office or data entry experience preferred.
• Must have High School Diploma/GED
• Strong 10 key skills by touch preferred.
• Minimum of 50 wpm typing speed
• Knowledge of medical terminology and how to read and locate information on insurance remittance advice or invoices preferred
• Nights/Weekends: Able to work overtime as needed with little to no notice
• Must be fluent in the written and verbal skills necessary to successfully perform the essential functions, duties, and responsibilities of the position.

About DaVita Laboratories

DaVita Labs is a state-of-the-art clinical laboratory delivering timely, accurate lab results focused primarily on kidney care with a relentless commitment to quality. We serve more than 180,000 patients and perform 52 million renal tests annually. We make a difference. We enjoy what we do. Our teammates are best in class professionals who enjoy a challenging yet rewarding work environment where fun and hard work intermingle every day. From our laboratory professionals to our support roles, DaVita labs not only offers a career to fit each individual, it provides a community and a place to call home. As a labs teammate, you become a member of our community and you also become a citizen of something bigger, something great, and something unique - the DaVita Village. With the backing of the overall DaVita brand, we are on an exciting trajectory.

Check out our short video to hear directly from teammates as to why YOU should join OUR Village!

Here is what you can expect when you join our Village:
* A "community first, company second" culture based on Core Values that really matter.
* Clinical outcomes consistently ranked above the national average.
* Award-winning education and training across multiple career paths to help you reach your potential.
* Performance-based rewards based on stellar individual and team contributions.
* A comprehensive benefits package designed to enhance your health, your financial well-being and your future.
* Dedication, above all, to caring for patients suffering from chronic kidney failure across the nation.

Want to make an impact in Healthcare? Through science, technology, quality and education, we are committed to expanding discovery and empowering lives. This empowerment comes in many forms. From our laboratory professionals to our support roles, DaVita labs not only offers a career to fit each individual, it provides a community and place to call home. Join us as we pursue our vision "To Build the Greatest Healthcare Community the World has Ever Seen."

What We'll Provide:

More than just pay, our DaVita Rewards package connects teammates to what matters most. Teammates are eligible to begin receiving benefits on the first day of the month following or coinciding with one month of continuous employment. Below are some of our benefit offerings.

• Comprehensive benefits: Medical, dental, vision, 401(k) match, paid time off, PTO cash out
• Support for you and your family: Family resources, EAP counseling sessions, access Headspace , backup child and elder care, maternity/paternity leave and more

• Professional development programs: DaVita offers a variety of programs to help strong performers grow within their career and also offers on-demand virtual leadership and development courses through DaVita's online training platform StarLearning.

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At DaVita, we strive to be a community first and a company second. We want all teammates to experience DaVita as "a place where I belong." Our goal is to embed belonging into everything we do in our Village, so that it becomes part of who we are. We are proud to be an equal opportunity workplace and comply with state and federal affirmative action requirements. Individuals are recruited, hired, assigned and promoted without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, protected veteran status, or any other protected characteristic.

This position will be open for a minimum of three days.

Compensation for the role will depend on a number of factors, including a candidate's qualifications, skills, competencies and experience. DaVita offers a competitive total rewards package, which includes a 401k match, healthcare coverage and a broad range of other benefits. Learn more at https://careers.davita.com/benefits

Colorado Residents: Please do not respond to any questions in this initial application that may seek age-identifying information such as age, date of birth, or dates of school attendance or graduation. You may also redact this information from any materials you submit during the application process. You will not be penalized for redacting or removing this information.